Urgent Urination
Urgent urination  [Urinary Incontinence, Frequent Urination]

Urgent urination, or urinary incontinence, is common among the older patients.
About one-third of all elderly residing in hospitals or nursing homes have urgent
urination, and about 10% of elderly living at home are incontinent.

In normal bladder function, nerves in the bladder signal the brain when the
bladder is filled with urine. This results in the urge to urinate. Just before
urination begins, the brain sends a signal to the large bladder muscle to
contract, to squeeze urine out. At the same time, the brain signals the sphincter
muscles around the urethra to relax so that urine can be released.

Urgent urination is an inability to control urination. A physician will diagnose an
urgent urination or bladder control problem after urinalysis, blood chemistries
and catheterization to determine residual urine volume, or the amount of urine
left in the bladder after voiding. The two most common types of incontinence
are called stress incontinence and urge incontinence (known as overactive
bladder).

Stress Incontinence: Stress incontinence is a leakage of urine that occurs
during certain everyday activities, such as sneezing, coughing, laughing or
lifting heavy objects. This type of incontinence is due to weakened sphincter
muscles around the urethra, a small amount of urine can escape. Stress
incontinence occurs most often in women, after pregnancy, menopause
(estrogen deficiency} or if they are obese. Drugs used to treat stress
incontinence include phenylpropanolamine, pseudoephedrine, imipramine and
estrogens. Exercises may help strengthen the pelvic floor muscles.

Urge Incontinence: An overactive bladder is simply the result of an unstable
large bladder muscle that contracts even when the bladder is not full. This type
of incontinence is common in older patients. Voiding may begin with little or no
warning. These patients may feel an urgency to urinate even when there is little
urine in the bladder. Urge incontinence is a result of inflammation or infection of
the urethra or kidney, kidney stones, kidney tumors, stroke, Parkinsonism or
spinal cord injury. Drugs used to treat urge incontinence include Detrol
(tolterodine tartrate), oxybutynin, imipramine, propantheline and dicyclomine.
Exercises and behavioral changes may help.

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Frequent urination is not exactly the same as urgent urination. Frequent
urination is a need to urinate more often than usual. As decribed above, urgent
urination is a sudden, compelling urge to urinate.

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